OXFORD RADCLIFFE HOSPITALS NHS TRUST
JOB DESCRIPTION SPECIALIST TRAINEE in NUCLEAR MEDICINE General Information District Served The population of central Oxford is 144,000 people. A wide range of general and specialist services are provided to the Oxfordshire population (550,000 in 1991), the other Districts within the South-East, South-West and Eastern Regions and a significant number of Districts from further afield. Oxford is within easy reach of London, 52 miles away, with regular rail and coach services. The nearby M40 motorway and other major roads also give fast access to the Cotswolds, the ancient market towns of Warwick, Banbury and Stratford-upon-Avon as well as central Birmingham. Oxford itself offers many attractions at several levels of interest. Historically, the presence of 37 colleges that comprise Oxford University - the oldest academic body in the English-speaking world - has left a rich tradition of history and world-famous architecture. Sports enthusiasts have access to sports and fitness centres, swimming pools, squash courts and an ice rink. Oxford and the surrounding area also have many football, rugby, hockey and cricket clubs for both players and spectators. The Oxford Radcliffe Hospital offers discounted membership at several local sports centres. As a leading university city with 14,000 students, Oxford offers a rich choice of lively and extensive entertainment for all tastes. The many theatres, cinemas, art centres and concert halls present a high calibre of programmes throughout the year. Oxford also supports several orchestras and choral societies that present regular concerts and welcome new members. Given its popularity and position as a centre of learning, rented accommodation in Oxford is not hard to find. Shared houses or flats are found either through local newspaper advertisements, by word of mouth or through letting agencies.
Facilities available Hospital Services: The Oxford Radcliffe NHS Trust hospitals are a major provider of health care, teaching, training and research. The services of the Trust are provided from three sites and encompass more than 1500 beds. It is anticipated that 260,000 people will attend as out-patients, over 97,000 patients will be admitted, and 90,000 will attend the accident and emergency department. Over 10,000 staff work on its three sites, including staff associated with the Clinical School, Oxford Brookes University and the research organisations. The three sites encompass:The John Radcliffe (1000+ beds), which is the main accident and emergency hospital, also provides general and specialist medical, surgical, trauma, cardiac, paediatric and women‟s services. In 2007, a West Wing was added to the hospital which provides a regional neurosciences and specialist surgical service including neurosurgery and neurology, cranio-facial surgery, plastic and reconstructive surgery, ENT and ophthalmology. The Churchill (330 beds), which has a number of specialist services including urology, clinical and medical oncology, palliative care, dermatology, infectious diseases, geratology, medical and clinical genetics and chest medicine. In addition it provides diabetes, endocrinology and metabolic services The Horton Hospital in Banbury (250 beds), which provides district general hospital services, including accident and emergency services, to its local population in the North of the county and in surrounding counties. The Horton Hospital serves a population of 160,000 with one of the fastest increasing populations in the country. The Trust works particularly closely with the University of Oxford, the Clinical Medical School and the School of Health Care Studies at Oxford Brookes University. The Trust values these links and sees great potential for even closer ties in the coming years.
Clinical Radiology Departments: General radiology, nuclear medicine, ultrasound, CT, MRI, angiography and interventional radiology are carried out at the John Radcliffe and Churchill Hospitals. Breast screening in based at the Churchill. Specialist neuroradiological, ENT and ophthalmic services are provided in a separate wing at the John Radcliffe Hospital. The Nuffield Orthopaedic Centre NHS Trust is a separate Trust providing specialist musculoskeletal services within Oxford.
Nuclear medicine: The John Radcliffe, Cardiac and Churchill nuclear medicine departments make up the three diagnostic nuclear medicine suites within the ORH NHS Trust. The John Radcliffe nuclear medicine department is located within the Radiology department. It contains an SMV Vision DST-Xli variable angle dual head gamma camera with SPECT capabilities, an SMV Vision powerstation (Clinical Application content V4.2.1) and a Hermes workstation. The John Radcliffe is the regional centre for paediatric urology and oncology, and requests from these clinical areas constitute the majority of the cameras workload. This area is staffed by 1 Superintendent radiographer, 1 rotatating Senior I radiographer and 1 Senior II radiographer, all of whom are trained in the administration of radionuclide injections. In addition there is a dedicated neurological triple headed Trionix Triad gamma camera. The cardiac nuclear medicine department is located adjacent to the cardiac centre within the John Radcliffe Hospital. th This service is under the direction of the cardiologists. The cardiac nuclear medicine department is the 4 largest in the country and has a considerable reputation in teaching and research. It sees about 2000 patients a year. The existing service is supported by Medical Physics department and technical staff. The cardiac gamma camera is a IS2 (twin head small field) system. The Churchill Hospital is the regional centre for oncology, renal medicine and transplantation, and diabetic, endocrinology and metabolic services. The nuclear medicine department is situated within the Radiology department and contains two GE Infinia dual head SPECT/CT gamma cameras. This site has both Hermes and Infinia workstations. The department is staffed by 2 Superintendent radiographers, 1 rotating Senior I and 2 Senior II radiographers. A fully equipped Amercare radio-pharmacy with facilities for cell labelling is located within Churchill Hospital. PET/CT is integrated within the Churchill Radiology Department. The PET/CT camera is a GE Discovery 690 with 64 slice CT with full cardiac and respiratory gaiting options. The workload is predominately Oncology FDG, performing over 2000 studies per annum including a small number of non-FDG studies. Currently PET/CT is reported on both Hermes and GE AW workstations. The Radiology department currently has 2 ARSAC Certificate holders (Dr KM Bradley & Dr FV Gleeson), with a third dedicated Consultant, Dr M Khonsari. Dr KM Bradley is the Consultant in Nuclear Medicine on the John Radcliffe site and Dr FV Gleeson leads the provision of nuclear medicine services at the Churchill Hospital. The radionuclide therapy service is performed by Radiotherapy consultants at the Churchill Hospital. This department contains 10 ARSAC license holders.
Examinations Performed Currently over 6000 adult and over 700 paediatric nuclear examinations are performed annually. In excess of 2000 clinical PET/CT examinations are performed annually.
Nuclear Medicine Physics Radionuclide Imaging Physics has an establishment of 5 Medical Physicists and 1 Medical Physics Technician (MTO) and forms part of the Department of Medical Physics. Other sub specialist groups within Medical Physics include Radiotherapy Physics, Imaging Physics and Clinical Physics. Radionuclide Imaging Physics provide support for Nuclear Medicine within Nuclear Cardiology and the John Radcliffe and Churchill Hospital departments.
Main conditions of service
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The post is covered by the Terms and Conditions of Service for Hospital Medical and Dental Staff (England and Wales) and the General Whitley Council Terms and Conditions of Service as amended from time to time at the Specialist Trainee grade. The hours worked will be in accordance with statutory obligations but, due to changing work patterns, will not necessarily all be within the hours of 9.00 a.m. to 5.00 p.m. It will be possible for a post holder to apply for flexible training if he/she so desires by application to the Postgraduate Dean.
Teaching Informal teaching of undergraduate medical students by junior staff in Radiology is expected at all times with more formal teaching sessions depending on the undergraduate programmes operating in the various rotations. It is a normal part of the duties of these posts to instruct junior radiological staff working under supervision.
Clinico-Radiological Meetings There are frequent clinical radiological meetings and multidisciplinary team meetings and trainees will be expected to attend and participate in as many of these meetings as possible. See sample timetable for a list of available meetings.
Research Research is actively encouraged throughout the training period. Laboratory and computing facilities are available, and study/research time is allocated. Bursaries are available to assist junior staff to present papers at international meetings abroad.
Administration Specialist Trainees are expected to take part in everyday organisation of the work in the radiology department and to attend audit meetings.
Study Leave Specialist Trainees are encouraged to attend approved postgraduate courses and scientific meetings. The Specialty Training Committee selects and approves the courses that are appropriate to attend, such as those organised by RCR. Specialist Trainees require the permission of supervising Consultants (College/Clinical Tutor) and the Head of the Training Programme to attend courses or meetings in the UK. Financial limits are imposed by the local Postgraduate organisation. Attendance at non-approved courses may be at the Specialist Trainee‟s own expense and taken as annual leave. There is also access to all postgraduate meetings and activities in the Oxford Radcliffe Trust. Facilities for Study and Training: Good Library facilities are available at the John Radcliffe Hospital and at other libraries in the Central Oxford Hospitals. Local facilities include the Radcliffe Science Library, Cairns Library and departmental libraries. The Barclay Kemp collection (all major radiological journals) is available in the MRI Unit at the John Radcliffe Hospital. The Department of Diagnostic Radiology in the John Radcliffe Hospital provides a small book and journal library and a film library. Regular continual assessment will be undertaken by Drs Bradley and Gleeson and at the end of each year an annual assessment and appraisal of each specialist registrar will be undertaken by the Training Committee. It is mandatory to maintain a Log Book and personal portfolio during the training period.
Postgraduate Programmes The University department organises evening lectures and other meetings appropriate for FRCR and post-FRCR st training. A comprehensive Part I FRCR course commences on 1 October annually.
On-call
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The duty Specialist Trainees are responsible for all radiological examinations requested and approved during the periods of emergency service for which they are on duty. They will ensure that no special examinations are carried out without their specific agreement. The hours of duty are from 5.00 p.m. until 9.00 a.m. the following morning each weekday and for 24 hours from 9.00 a.m. on Saturday, Sunday or Bank Holidays. Specialist Trainees will not be resident in the hospital. It is the duty Specialist Trainees responsibility to contact the consultant on-call if necessary.
The post is whole time: the duty hours will be the standard working week of 40 hours. st
With effect from 1 December 2000 the remuneration received is appropriate to the “banding” of this post, in accordance with the new junior doctor pay deal and contract.
Conditions of Appointment As per person specification. A minimum of 2 years‟ general professional training is required for candidates proceeding to CCT in nuclear medicine. Satisfactory pre-employment health screening. Accommodation This is a non-resident appointment (no accommodation is available). For further information contact: Dr Kevin Bradley, Consultant Radiologist and Nuclear Medicine Physician (tel:01865 235733), John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU or Dr Fergus Gleeson, Consultant Radiologist (01865 235746), Department of Radiology, Churchill Hospital, Headington, Oxford, OX3 7LJ.
Main Conditions of Service Appointments to this programme are subject to the Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales). In addition appointments are subject to: Applicants having the right to work in the UK Registration with the General Medical Council Pre-employment checks carried out by the Trust HR department, including CRB checks and occupational health clearance. The employing Trust‟s offer of employment is expected to be on the following nationally agreed terms: Hours – The working hours for junior doctors in training are now 48-hours (or 52-hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors in training also have an individual right to opt-out if they choose to do so, but they cannot opt-out of rest break or leave requirements. However, the contracts for doctors in training make clear that overall hours must not exceed 56 hours in a week (New Deal Contract requirements) across all their employments and any locum work they do.
http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWTD/Pages/EWTD.a spx Pay – you should be paid monthly at the rates set out in the national terms and conditions of service for hospital medical and dental staff and doctors in public health medicine and the community health service (England and Wales), “the TCS”, as amended from time to time. The pay scales are reviewed annually. Current rates of pay may be viewed at http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedicalandDental.aspx Pay supplement –depending upon the working pattern and hours of duty you are contracted to undertake by the employer you should be paid a monthly additional pay supplement at the rates set out in paragraph 22 of the TCS. The current pay scales may be viewed at http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedicalandDental.aspx . The pay supplement is not reckonable for NHS pension purposes. The pay supplement will be determined by the employer and should be made clear in their offer of employment and subject to monitoring.
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Pension – you will be entitled to join or continue as a member of the NHS Pension Scheme, subject to its terms and rules, which may be amended from time to time. If you leave the programme for out of programme experience you may have a gap in your pension contributions. More information can be found at http://www.nhsbsa.nhs.uk/pensions Annual Leave – your entitlement to annual leave will be five or six weeks per annum depending on your previous service/incremental point, as set out in paragraphs 205-206 of the TCS. The TCS may be viewed at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPREG/Pages/DoctorsInTrainin g-JuniorDoctorsTermsAndConditions150908.aspx Sick pay – entitlements are outlined in paragraph 225 of the TCS. Notice –you will be required to give your employer and entitled to receive from them notice in accordance with paragraphs 195-196 of the TCS. Study Leave –the employer is expected to offer study leave in accordance with paragraphs 250-254 of the TCS. Local policy and procedure will be explained at induction. Travel Expenses – the employer is expected to offer travel expenses in accordance with paragraphs 277-308 of the TCS for journeys incurred in performing your duties. Local policy and procedure should be explained at induction. Subsistence expenses – the employer is expected to offer subsistence expenses in accordance with paragraph 311 of the TCS. Local policy and procedure should be explained at induction. Relocation expenses – the employer will have a local policy for relocation expenses based on paragraphs 314 – 315 of the TCS and national guidance at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPREG/Pages/DoctorsInTrainin g-JuniorDoctorsTermsAndConditions150908.aspx. You are advised to check eligibility and confirm any entitlement with the employer before incurring any expenditure. Pre-employment checks – all NHS employers are required to undertake pre-employment checks. The employer will confirm their local arrangements, which are expected to be in line with national guidance at http://www.nhsemployers.org/RecruitmentAndRetention/Employment-checks/Pages/Employment-checks.aspx Professional registration – it will be a requirement of employment that you have professional registration with the GMC for the duration of your employment. Though the post is covered by NHS Indemnity, you are strongly advised to register with the MPS for professional indemnity. Health and Safety – all employers have a duty to protect their workers from harm. You should be advised by the employer of local policies and procedures intended to protect your health and safety and expected to comply with these. Disciplinary and grievance procedures – the employer will have local policies and procedures for dealing with any disciplinary concerns or grievances you may have. They should advise you how to access these, not later than eight weeks after commencement of employment. Educational Supervisor – the employer or a nominated deputy (usually the Director of Medical Education) will confirm your supervisor on commencement. General information on the Deanery‟s management of Specialty Training programmes, including issues such as taking time out of programme and dealing with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the national „Gold guide‟ to Specialty Training at http://www.mmc.nhs.uk
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WEEKLY PROGRAMME (Year 5) RADIONUCLIDE RADIOLOGY
AM
Meetings
PM
MONDAY
Nuclear Medicine Reporting
Upper GI MDT - CH Hepatobiliary MDT – CH Colorectal MDT – CH Gynaecology MDT – JR Paediatric Surgery CRM – JR
STUDY
TUESDAY
Nuclear Medicine / Ultrasound
Oncology CRM – Churchill Endocrine CRM – Churchill Renal CRM – Churchill
PET/CT
WEDNESDAY
Nuclear Medicine Reporting/Nuclear Cardiology
Thoracic MDT – Churchill Lymphoma MDT – JR
Nuclear Cardiology
THURSDAY
CT Reporting
General Medicine CRM – JR Medical Grand Round – JR
Nuclear Medicine Reporting
FRIDAY
Nuclear Medicine & MRI Reporting
Surgical Grand Round – JR Infectious Diseases CRM – Churchill Neurosciences CRM – JR Urology MDT – Churchill
Nuclear Medicine
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WEEKLY PROGRAMME (Year 6) NUCLEAR MEDICINE
AM MONDAY
General NM Reporting (JR) Upper GI MDT (CH)
TUESDAY
PET/CT Reporting (CH) Neck or (Thyroid/parathyroid etc) Ultrasound
WEDNESDAY
PET/CT Reporting (CH)
Meetings
PM
Upper GI MDT - CH Hepatobiliary MDT – CH Colorectal MDT – CH Gynaecology MDT – JR Paediatric Surgery CRM – JR
Thyroid Clinic and Radionuclide Therapy (CH)
Oncology CRM – Churchill Endocrine CRM – Churchill Renal CRM – Churchill
PET/CT Reporting (CH)
Thoracic MDT – Churchill Lymphoma MDT – JR
PET/CT Reporting (CH) Combined oncology-surgery thyroid clinical (CH, monthly)
THURSDAY
CT (JR)
FRIDAY
Study Research Infectious Diseases, monthly clinico-radiological meeting (CH) Hepatobiliary MDT (CH)
General Medicine CRM – JR Medical Grand Round – JR Surgical Grand Round – JR Infectious Diseases CRM – Churchill Neurosciences CRM – JR Urology MDT – Churchill
PET/CT Reporting (CH)
Radionuclide therapy (CH) General NM Reporting (CH)
Additional ad hoc radionuclide therapies, neuroendocrine & endocrine MDT.
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